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Thread: Ttc 2013

  1. #171
    Join Date
    Sep 2012
    Location
    Los Angeles
    Posts
    4,279
    @alzora:

    Damage to the urethra and bladder won't impact fertility. The bony pelvis reconstruction with implanted hardware defInitely doesn't matter-- though as I wrote above to ottilie, the pelvic ligaments do relax at the very end of pregnancy in order to make the birth even easier, so that particular joint at least will not be able to do so.

    The vagina is not a reproductive organ, just a conduit. It's actually rather unimportant in the whole process. The only thing I can think of is with the scarring postoperatively you will have an unaturally high %age of collagen in the vaginal walls making them both weaker and less stretchy. You might be more prone to soft tissue damage during delivery, even severe soft tissue damage as you shared you had vaginismus with intercourse alone [and a baby is a lot bigger!]. That would be the #1 thing I would discuss with your OB, to see whether or not you would need an elective c-section or she thinks the repair would hold under the extreme stress of childbirth.

    Re: being underweight: a great deal depends on your BMI, not your actual weight. If you're <5 feet tall then 100lbs is a healthy weight. But yes, being underweight-- even if cycling-- can make you subfertile, and weight loss from an already low weight does induce miscarriage. It's a survival mechanism back from when humans had a much less secure food supply and a pregnancy could kill a malnourished mother. The bottom line is that fat secretes estrogen, and cholesterol is used as the substrate from which estrogen is synthesized. Low %age body fat alters the hormone balance in the body, and low estrogen / progesterone levels might be enough to affect the uterus and cause the monthly endometrial buildup and shedding without stimulating enough FSH/LH to ovulate.
    Blade, MD

    XY: Antoine Raphael (3.1.2012)
    XX: Cassia Viviane Noor (11.30.2013)

  2. #173
    Join Date
    May 2012
    Posts
    1,809
    Thanks, blade! I didn't even think about the vagina not allowing a baby through. My doctors consulted on whether my pelvis would allow a baby to pass through, but even in light of the vaginismus I never thought to ask about whether a baby could pass through the vagina. I will bring that up next time I see my doctor. Thanks for the tip. The biggest concern I have with pregnancy--that is, delivery--is bleeding, actually. Bleeding is what nearly killed me the day of the accident, and I left a trail of blood from the ambulance to the operating table. In total I lost my entire blood volume three times. Doctors literally couldn't keep track of the number of units they were giving me. When the bleeding started up a second time, they were seconds away from telling my family they were sorry. Thankfully they had the resources to try again, and the bleeding eventually stopped for good. (I've actually been a local spokesperson for Red Cross because of this, via local radio and TV stations, and I thank donors profusely.) So my concern is this. Will those blood vessels in the pelvic area be at risk of rupturing again during labor and delivery? Are they all weaker now? Could they have been rearranged in there in a particularly risky way that could cause problems during labor? I know this is something I will have to ask my doctor about, but maybe I should seek an answer BEFORE conceiving.

  3. #175
    Join Date
    Sep 2012
    Location
    Los Angeles
    Posts
    4,279
    No that is entirely due to the fracture. When the bony pelvis shatters bone fragments lacerate the soft tissue (which is why we always check for bowel and urogenital injuries in the trauma bay) and the fragments may also lacerate the vasculature. Most lifethreatening bleeding from pelvic fractures is venous, from multiple small unnamed veins (about 70% of the time) but if you had an arterial injury that could explain such massive blood loss. Death from pelvic fractures is nearly always due to this.

    Anyway that sort of injury is actually relatively easy to control-- clamp on either side of the vessel, repair the injury, and pack the pelvis to control all those small veins. Once fixed, it's fixed.

    Hemorrhage in childbirth is almost always uterine in origin. There are literally thousands of small arterial connections from mother to placenta. Normally after delivery of the baby these clamp off as the uterus contracts back to normal; the placenta separates safely. However if the uterus doesn't clamp down, or if part of the placenta is retained, quickly life-threatening hemorrhage can result. There is absolutely no reason ahead of time to think you would have a problem, any more than anybody else.
    Last edited by blade; February 17th, 2013 at 11:19 AM.
    Blade, MD

    XY: Antoine Raphael (3.1.2012)
    XX: Cassia Viviane Noor (11.30.2013)

  4. #177
    Join Date
    May 2012
    Posts
    1,809
    That is extremely enlightening. Thank you! You have no idea what a huge concern that alleviates. So I might be in better shape for a pregnancy than I thought. Your feedback is much appreciated. I apologize to the other posters for taking over this thread with my medical history. Most of your posts are about things others can relate to, but I guess my recent posts don't contain relevant "fertility issues." We can go back to regular TTC talk; blade has answered my questions and put my mind at ease. Thanks again.

    @poppy and roseymaam, I'm sorry you're both facing disappointments. It's a horrible feeling. I'm usually pretty down for a few days, but I tend to cheer up within the week. I hope you can find ways to cheer up as well, but I know it sucks. I'm already disappointed about this cycle; only a week past ovulation, give or take, but I feel 100% normal with zero symptoms except my PMS insatiable appetite, so I fully expect AF to come in 7-8 days and we will proceed with Cycle 7. Until then, I guess we're still in Honeymoon Phase, so I'll make the most of it.

  5. #179
    Join Date
    Dec 2012
    Location
    Texas
    Posts
    914
    Alzora, best wishes to you. Hope is pretty awesome. :-)

    I am having laparoscopic ovarian drilling this Wednesday to reduce ovarian mass and make room for eggs to pop out. My ovaries are so cystic right now doc said Clomid would prob be a waste of time. I start Clomid after the procedure. He said for at least 6 months following the procedure my odds of getting pregnant will go from roughly 0% to about 50%, assuming all goes well and no tubal blockage. I am hopeful. I'm Catholic. It's Lent. I'm praying my ass off for a baby. St. Jude is sick of me. Seriously.

    @Blade, we had discussed low-carb diets and homeostasis on another thread. I decided to take your advice and try busting my ass with physical activity for the first time in years, and not being so strict about the diet. So I started running with my husband, but FOR REAL this time. I was pretty sure I was gonna stroke out at first but after a few days I can jog my big butt almost a mile without stopping to walk. Including walking I'm doing 1.5 miles a day right now, about 25 minutes, every other day. It's hard, but I know it's good for me. The bad thing is it sends my appetite through the roof. It makes me want chocolate. Hubs assured me this is normal and will even out.

    Instead of focusing so completely on food I'm trying to just be active and chill the hell out. I've been on a diet virtually non-stop for literally as long as I can remember. I'm just profoundly over it.

    Thanks again for your advice and good luck to all you ladies trying to get healthy as part of your TTC journey!
    Mrs. H.
    Trying for our first!
    If it's a boy: Josiah Walker "Joe"
    If it's a girl: Clementine Marvel
    Avatar: "Dark Robe" by Malcolm Liepke

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